CLIA lab
CLIA 24D1042492: Phoenix Residence Viking
Little Canada, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D1042492 belongs to Phoenix Residence Viking in Little Canada, MN.
Certificate of Waiver, effective April 12, 2026, expires April 11, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- April 12, 2026
- Certificate expiration
- April 11, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 30, 2005
- Facility type
- Intermediate care facility for individuals with intellectual disabilities
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 24D1042492
- Lab name
- Phoenix Residence Viking
- Address
- 645 Viking Drive East, Little Canada, MN 55117
- Phone
- (651) 294-2076
- Fax
- (651) 294-2077
Annual test volume the lab reported
- Waived tests
- 12
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Little Canada, MN
- Advanced Medical Home Care LLCCertificate of Waiver, Home health agency24D2063259
- Chirome Health and Wellness LLCCertificate of Waiver, Physician office24D2276203
- Grand ST Paul CVS, LLC DBA Cvs/Pharmacy #04573Certificate of Waiver, Pharmacy24D2279593
- Suite Living Memory Care & Assisted LivingCertificate of Waiver, Assisted living facility24D2165004
- Women's Life Care CenterCertificate of Waiver, Community clinic24D2164590
Related
Questions
What is the CLIA number for Phoenix Residence Viking in Little Canada?
24D1042492, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Phoenix Residence Viking hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D1042492 expire?
The CMS file lists April 11, 2028 as the certificate expiration date; the certificate took effect April 12, 2026.